Digital Commons Network^™

Standardizing Genomic Testing Of Pancreatic Cancer In A Community Oncology Practice, Julie Marie Scott

Dissertations

Problem. Ordering genomic testing for patients with pancreatic cancer can discover germline or somatic mutations that may allow for targeted therapy. There are some difficulties in obtaining genomic tests, such as which test to order, and optimal timing of ordering. In addition, interpreting results and maintaining easy access to the report in the electronic medical record can be difficult. Delays in ordering genomic testing can delay the discovery of an actionable mutation for treatment.

Methods. A descriptive comparison project was developed comparing rates and timing of ordering of genomic testing for patients with pancreatic cancer who established care with a …

Identification Of Veterans Experiencing Symptoms Of Mental Illness For The First Time After Covid-19 Diagnosis, Brittania Phillips

Dissertations

There has been a general increase in psychiatric symptoms since the COVID-19 pandemic began. Literature that has been published since the start of the pandemic has indicated there is an increased risk of depression, insomnia, altered mental status, new-onset psychosis, neurocognitive syndrome, and anxiety. The military veteran population is at higher risk for psychiatric illness than the general population, and should be screened accordingly. This quality improvement project was developed in collaboration with the mental health clinic at urban medical center in the Midwest to identify new symptoms of mental illness after COVID-19 diagnosis utilizing the PDSA model and descriptive …

Implementing A Depression Screening In A Pediatric Acute Care Setting For Adolescents With Type 1 Diabetes, Kelcie Marler

Dissertations

Problem: Depression among adolescents with Diabetes Mellitus type 1 (DM 1) is three times more prevalent than adolescents without chronic disease. Diagnosis of depression has been found to negatively affect the quality-of-care management, quality of life, and results in an increase in hospital admissions with hypoglycemia or hyperglycemia events.

Methods: A depression screening, the patient health questionnaire 9 (PHQ-9), a validated screening tool for use among adolescents was implemented in this quality improvement (QI) project. It was the first cycle of a plan-do-study-act (PDSA) cycle for in a pediatric ICU. Adolescents between the ages of 12 – 18, were …

A Standardized Approach To Awakening And Breathing Trials, Maureen Awuor Abongo

Dissertations

Abstract

Problem: Mechanical ventilation with sedation, are crucial co-therapies for the critically ill. Risks of both, known as Ventilator Associated Events( VAEs), can worsen outcomes. Performing Spontaneous Awakening Trials (SATs), with Spontaneous Breathing Trials(SBTs), is a targeted evidence-based strategy in reducing VAE rates. The Intensive Care Unit (ICU) lacked a coordinated approach to operationalizing SATs with SBTs.

Methods: An observational retrospective study involving a review of VAE and patient data for corresponding months in years before, and after an improvement strategy application, and making comparisons. The multimodal strategy includes filling out checklists outlining criteria for performing a SAT with …

Evaluation Of A Dirfloortime® Program For Autism Spectrum Disorder, Jennifer L. Pipitone

Dissertations

Problem. Parents with children who have neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) experience high levels of parenting stress. The prevalence of ASD is on the rise in the United States. As a result, there has been an increase in the use of treatment modalities, in effort to better understand which modalities have the most positive impact on children and their parents. DIRFloortime® is a developmental treatment modality used to help strengthen the parent-child bond and used to decrease parental-child stress. The Autism Parenting Stress Index (APSI) measures the impact of an intervention …

Proactive Text Messaging For Public Health Surveillance During The Covid-19 Pandemic, Daria Kester

Dissertations

Problem

The Department of Public Health (DPH) of a suburban Midwestern county considers surveillance and control of COVID-19 to be sub-optimal, resulting in part from difficulties with completing case and contact interviews.

Methods

To increase the success rate of case investigation, proactive messaging using short message media (SMS) alerts is used in a quality improvement initiative based on the PDSA framework. Participants are sent text message alerts prior to receiving a call from a DPH case investigator. Results are recorded in a statewide database.

Results

Individuals who received text messages prior to receiving a case investigation interview phone call were …

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

Digital Contact Tracing During The Sars-Cov-2 Pandemic, Erin Katherine Moran

Dissertations

Problem

Manual contact tracing (MCT) is considered an essential public health intervention for infectious disease control. During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, there was insufficient funding or personnel to reduce transmission effectively. Throughout the pandemic, Missouri remained below the recommended contact tracing response rate (CRR) of 50%. One method used globally to aid in pandemic control was digital contact tracing (DCT); however, Missouri was unable to implement digital contact tracing due to barriers faced, which were not unique.

Methods

DCT was selected as subject of a strategic plan (SP) to augment MCT efforts. Other locales’ successes …

Mental Health Effects Of The Covid-19 Pandemic On Older Adults, Elizabeth Kerr

Dissertations

Problem: Significant psychological effects such as anxiety, depression, stress, and loneliness are shown to affect the older adult population, aged 65 years and older. The social isolation and disconnectedness related to the COVID-19 pandemic potentially worsens anxious and depressive feelings, increasing the risk for adverse outcomes in the high-risk older adult population. This project aimed to identify older adults at risk for acute, situational mental health issues associated with the pandemic.

Methods: A descriptive study design was used. Telephone interviews were conducted to explore effects of the COVID-19 pandemic on mental health responses in older adults. A convenience sample …

Youth Sports In A Pandemic Age, Robert Bohnert

Dissertations

Abstract

Problem: Youth sporting events is a public health concern as infected youth with coronavirus disease 2019 may unknowingly spread the virus, as many show little to no symptoms (Zimmerman & Nigel, 2020). This project aimed to identify level of adherence to posted Youth Sports Guidelines, which were designed to mitigate the spread of virus at youth sporting events.

Methods: An observational descriptive design was utilized. Two observers tallied guideline violations by participants and spectators at six high-contact (basketball) and six low-contact (swimming) public high school youth sporting events.

Results: A total of 726 youth sport participants and 139 …

The Effects Of Race, Ethnicity, Education, Marital Status, And Family Size On Hysterectomy Rates, Zula Price

Dissertations

Decreasing disparities in hysterectomy rates have been a goal of the United States Department of Health and Human Services as a method of improving women's health. In the United States, hysterectomy rates remain high, particularly among Black women in contrast to other racial and ethnic groups (Qi et al., 2013). This study, using a descriptive research framework, utilized a sample of 1,921 women across the United States who participated in the 2012 National Health and Nutrition Examination Survey (NHANES).

Data were analyzed from the responses of subjects who reported having a hysterectomy in the 2012 NHANES, which is designed to …

A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad

Dissertations

Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff's minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging …

Holistic Blood Pressure Management Plan In Primary Care, Marilyn L. King

Dissertations

The purpose of this Doctor of Nursing (DNP) quality improvement (QI) project was to demonstrate the usefulness of implementing a bilingual educational module for patients with hypertension on improving knowledge, self-efficacy, and self-management at Kids Kare Pediatrics and Family Kare Clinic.

A Screening Tool To Identify Patients At High Risk For Perioperative Neuropathy, Carla M. Ibbotson

Dissertations

This project aimed to evaluate anesthesia provider attitudes surrounding the clinical topic of perioperative peripheral nerve injury. Additionally, the project sought to introduce anesthesia providers to a novel risk assessment device that may help identify patients at high risk for perioperative peripheral nerve injury while assessing its potential utility in anesthesia practice.

Factors That Affect Adequate Analgesia In African Americans With Cancer Pain, Navdeep Singh

Dissertations

Receiving adequate analgesia has been shown to be problematic for African Americans with cancer pain. The vast majority of studies only simply highlights the existing disparities between African Americans and Caucasians in pain management. There is a lack of research focusing on the etiology of these disparities, specifically on what causes prescriptions for inadequate analgesics, especially for African Americans. The purpose of this study was to characterize the adequacy of analgesia received by African Americans with cancer pain and to elucidate what patient characteristics contributed to receiving adequate analgesia.

Clinicians' Use Of Mhealth Applications In Interventions For Substance Use Disorders, James Daniel Bender

Dissertations

The purpose of the study was to examine how clinicians are identifying, evaluating, and utilizing mHealth apps as treatment adjuncts with their clients who have a substance use disorder. A sample of 93 participants (20 males, 72 females, and 1 not listed) completed measures of demographics and inquiries about their use and evaluation of mHealth apps in their practices. Clinicians who work at mental health centers and private practicing clinicians were recruited. The majority of the sample (71%) reported that they had not utilized mHealth apps with their clients who have a substance use disorder diagnosis. Participants who have attended …

What You Speak Shall Come: Examining Spirituality On Retention Of African American Males Attending A Predominantly White Institution Using A Sequential Explanatory Mixed-Methods Design, Carlous Brian Yates

Dissertations

African American males have faced significant challenges at institutions of higher education over the years (Harper, 2013; Griffith et al., 2019). This study aimed to examine the impact of spirituality on the retention of African American males attending a Predominantly White Institution (PWI) through a sequential explanatory mixed-methods design study.

The participants in the study were African American males (N = 47) with age range 18 to 48 years old all attending a mid-sized university located in the mid-western region of the United States during the Fall 2020 and Spring 2021 semesters. The university is considered a Predominantly White Institution …

Examining Treatment Acceptability Of An Eight-Week Mindfulness-Based Stress Reduction Protocol, Blake William Palmer

Dissertations

The goal of this study is to examine whether levels of perceived stress, experiential avoidance, personality traits including openness to experience and agreeableness, and demographic variables will predict the treatment acceptability (indicated by responses on the Treatment Acceptability and Adherence Scale) of an eight-week Mindfulness-Based Stress Reduction (MBSR) program. This study collected data in the Spring of 2019. The final number of participants in the study was 116 (40 females, 76 males, Mage = 36, age range: 22-69 years). Participants completed measures including the Perceived Stress Scale (PSS), Acceptance and Action Questionnaire-II (AAQ-II), the agreeableness and openness to Experience domains …

Development Of A Scale To Measure School Psychologists' Self-Efficacy For Working With Gifted Populations, Brittany Marie Dodds

Dissertations

School psychologists are specialists in educational assessment, consultation, youth mental health, and social-emotional-behavioral development. As a result of their training, school psychologists are positioned to serve students with exceptionalities, including gifted students. However, research indicates that school psychologists' familiarity with gifted issues is lacking and that information regarding school psychologists' self-efficacy for working with this population is nonexistent. Therefore, the aim of the present study was to create a tool to assess school psychologists' self- efficacy for working with gifted populations. The Dodds Inventory of Gifted Self- Efficacy for School Psychologists (DIGS-SP) was developed and administered to 229 practicing school …

High School Principals’ And Assistant Principals’ Perceived Knowledge Of Career And Technical Education, Sara Jo Greene

Dissertations

An employment crisis is ever growing in Kentucky. Business and industry continue to search for reliable skilled employees without success. These representatives have started looking at local high school and technical education centers to help fill these employment gaps. Career and Technical Education (CTE) provides students with a strong foundation to become a well skilled, employable individual who will make a great employee. Although CTE programs are available throughout the state of Kentucky, enrollment is not where it should be. The purpose of this study was to examine the relationship of perceived knowledge of CTE held by Kentucky high school …

Examining The Effects Of A Curriculum-Based Professional Learning Community On Teacher Efficacy Toward Inquiry-Based Science Instruction, Samuel Joel Northern

Dissertations

Improving STEM education is pivotal to our country’s economic future and security. Unfortunately, most young students have limited access to standards-based science education. Science instruction is notoriously difficult to implement in the early grades. This dissertation explored the root causes for the lack of effective science instruction in elementary schools, including accountability testing, instructional time, historically weak standards, family factors, teacher efficacy, and professional development.

This study aimed to understand how elementary school teachers’ attitudes promote or hinder the implementation of science instruction. This study’s primary driver to improve science education in the early grades was a curriculum-based professional learning …

Nurse Residency Program Use In Alabama Hospitals: Exploring The Decision-Making Strategies Of Hospital Administrators, Miranda M. Smith

Dissertations

Current literature supports the creation and implementation of nurse residency programs to support new graduate nurses as they transition into nursing practice. Additionally, nurse residency programs have been shown to increase nurse satisfaction and retention (Crimlisk et al., 2017; Olson-Sitki et al., 2012). Currently, there are only three nurse residency programs in the state of Alabama. The lack of this important post-licensure resource poses a problem for new graduate nurses who are seeking additional assistance and guidance during the transition to professional practice.

This qualitative study examined the decision-making process of hospital leaders in the implementation of the nurse residency …

Postpartum Depression In South Asian American Mothers: An Examination Of Screening Tools And Associated Cultural Factors In Assessment, Heer Panchal

Dissertations

Postpartum depression is a disorder impacting an overwhelming number of women after childbirth with symptoms of depression, anxiety, guilt, and hopelessness. Due to limited research and understanding of postpartum depression in the growing South Asian population in the United States, it is vital to gather data and research on this population to increase understanding of patterns and experiences that occur within the South Asian American population and to incorporate cultural factors into the screening process. The current research’s objectives include discussing the facets of postpartum depression, current tools used to screen for postpartum depression, and helpful interventions to create a …

Local Food In Tourism: An Investigation Into Food Offerings At Irish Visitor Attractions—Are We Telling The Right Story?, Kate O Hora

Dissertations

This study’s aim is to investigate food offerings at visitor attractions in Ireland. Recent comments by Fáilte Ireland regarding food at visitor attractions has called on operators to localise their food offerings. A sample of eleven providers of food at visitor sites were invited to participate in qualitative interviews, to conceptualise their experiences with the provision of local food. The results showed that the sector had an overall interest in local food with most of the participants recognising that not enough emphasis was being placed on its promotion. The results of the study reveal that provision of local food provides …

The Effect Of Pedagogical Agent Persona On Performance, Self-Efficacy, And Attitudes In Adult Learners In An Online Environment, Justin L. Mathews

Dissertations

Pedagogical agents, virtual avatars that are often included in online training or educational modules, have been studied in a variety of disciplines to determine the extent to which their inclusion in online or multimedia learning environments may influence both cognitive and affective outcomes in learners. The present study examined the effect of a peer-like pedagogical agent providing motivational messaging in an online English language learning environment to determine if the agent will positively affect college students’ performance, self-efficacy, and attitude in comparison to a control group. All participants studied an online, self-paced English grammar module, either with (treatment version) or …

The Influence Of Professional Development On Teacher Self-Efficacy In Gifted Education, Keely P'Pool

Dissertations

The purpose of this research is to study the impact of effective professional development training provided to both preservice and inservice teachers about gifted education and gifted students. This research also seeks to discover whether a notable difference exists between preservice and inservice teachers in regard to the increase in their knowledge and self-efficacy upon completion of the professional development training. A quantitative approach using a survey and a required training was used for all participants. Study participants included preservice teachers attending a southern Kentucky public university who were taking education classes as well as inservice teachers from 11 school …

Examining The Psychological Effects Of Adolescent Bullying In Adults, Douglas Caro

Dissertations

Being an adolescent victimized by bullying is not only widespread but all too common in a society that deems it a “normal” rite of passage. However, bullying in schools has received increased attention since school shootings have inundated the media and news headlines the last several years. Some have correlated bullying to the shooters being bullied themselves. Being a victim of bullying has been linked to serious medical and mental health problems, not just in adolescents but across the lifespan. It is common for victims to experience physical problems such as abdominal pain and other gastrointestinal concerns. Mental health problems …

Teacher Biases And Expectations: Impact On Self-Esteem, Self-Efficacy, Delinquent Behavior Among Black Grade School Students, Rhonda Lloyd

Dissertations

Black children and adolescents in today’s society face so many challenges that come about from the hands of authority figures in their life, their environment, the education system, and society as a whole. Through a critical review of literature, the author sought to answer three research questions: (1) What are the indications that teachers may be more biased toward Black students? (2) How do perceived teacher biases and discrimination impact the self-esteem and self-efficacy of Black students? (3) How are teacher bias and the school-to-prison pipeline connected? The literature review exposed a need for a teacher training model, which was …

A Study On How Retired U.S. Army First Sergeants Led Their Troops Throughout Turbulent Times In Afghanistan During Operation Enduring Freedom Or Operation Freedom Sentinel, Enrique Ortega

Dissertations

Purpose: The purpose of this qualitative study was to discover and describe behaviors that retired U.S. Army First Sergeants (1SG) applied to lead their troops through turbulent times using the leadership attributes of moral purpose, concern for the collective interest, resilience, and personal temperament during combat operations.

Methodology: This qualitative study used a phenomenological approach to capture data from 10 retired U.S. Army 1SGs in the South Puget Sound area in Washington State who led their companies in Operation Enduring Freedom (OEF) and Operation Freedom Sentinel (OFS). Data were collected from 10 interviews and 71 artifacts of Disabled Americans Veterans …

Does The Input Equal The Outcome For Students With Emotional And Behavioral Disabilities?, Brigid Eileen Bright

Dissertations

Students with emotional and behavioral disabilities experience poor post-secondary outcomes despite the existence of research-based best practices to improve outcomes (Freeman et al., 2019; Mitchel et al., 2019). Research signifies this population as underserved and under-identified (Barnett, 2012). Additionally, funding best practices indicate student outcomes should be considered when allocating resources (Chartrand, 2019). The purpose of this mixed methods study was to consider both inputs and outcomes for graduates with emotional and behavioral disabilities (EBD) and graduates with significant cognitive impairments (SCI) in a rural northwest Arkansas district and the fiscal allocation for both populations. A comparison of quantitative post-secondary …